What is Pre-Diabetes?

Diagnosis, Treatment, and Prevention -- By Liza Barnes & Nicole Nichols, Health Educators
Before developing the serious health condition of type 2 diabetes, a person will almost always have pre-diabetes beforehand. But pre-diabetes is a condition without symptoms, meaning that many people can have it without even knowing it. Left unchecked, pre-diabetes can lead to full-blown type 2 diabetes, heart disease and stroke. Luckily, pre-diabetes can be diagnosed with a simple test, and treatment can prevent many health problems and complications. Here's what you need to know to control pre-diabetes before it gets control of you.

Diabetes Basics
Under normal circumstances, the glucose (sugar) levels in your blood rise after you eat a meal or snack. In response, your body produces a hormone called insulin, which is needed for the body to convert the glucose in your bloodstream into usable energy. But if insulin isn’t available, or if the body isn’t using it correctly, your blood glucose will remain elevated, and that can be harmful to your body. This is a condition known as diabetes. People who have higher-than-normal blood glucose levels that aren’t quite high enough to be diagnosed as type 2 diabetes have pre-diabetes. In the past, individuals with pre-diabetes would have been considered "borderline diabetic."

Who's at Risk?
Over 50 million Americans over the age of 20 have pre-diabetes, according to the American Diabetes Association. If you have any of the risk factors for type 2 diabetes, including uncontrollable factors like age and race, and/or controllable risk factors like obesity and physical inactivity, then you are also at risk for pre-diabetes.

Most of the time, pre-diabetes is asymptomatic (shows no symptoms), but some people will experience some general diabetes symptoms like extreme thirst, frequent urination, fatigue and/or blurred vision.

If you fall into any high-risk categories or experience any of the symptoms above, then visit your health care provider for a blood glucose test as soon as you can. Early diagnosis and treatment are crucial steps, as they can prevent the development of type 2 diabetes and its serious health consequences. <pagebreak>

Testing & Diagnosis
There are two tests commonly used to diagnose diabetes and pre-diabetes: a fasting plasma glucose (FPG test) and an oral glucose tolerance test (OGTT).

The FPG test will measure your blood glucose level after an eight-hour (overnight) fast. A result less than 100 mg/dL is considered normal, but anything above that level is diagnosed as "impaired fasting glucose" (IFG). Between 100 mg/dL and 125 mg/dL is considered pre-diabetes, while 126 mg/dL or higher indicates diabetes.

The OGTT will measure your blood sugar after a fast and then again after drinking a glucose-rich beverage. Two hours after the beverage, a result less than 140 mg/dL is considered normal, but anything above that level is diagnosed as "impaired glucose tolerance (IGT). Between 140 mg/dL and 199 mg/dL is considered pre-diabetes, while 200 mg/dL or higher indicates diabetes.

Some people have both IFG and IGT.

<pagebreak>Treatment & Prevention
While pre-diabetes in itself isn’t necessarily dangerous, the fact is that many people with pre-diabetes will develop type 2 diabetes within 10 years.

If you have pre-diabetes, realize that you’re fortunate to have found out while there is still a lot you can do to prevent or delay the development of type 2 diabetes. Here are some preventative measures:

Lose weight. In a study of more that 3,000 people with pre-diabetes, a five to seven percent weight loss (about 10 pounds for a 200-pound person) lowered the incidence of type 2 diabetes by nearly 60 percent. Follow the SparkDiet to reach your weight loss goal.

Get active. Physical activity (and its accompanying weight loss) will lower your risk of developing type 2 diabetes and boost you health in other ways too. Try walking 30 minutes a day, five days a week. Read about Exercising with Diabetes for more tips.

Eat sensibly. Cut excess calories, sugar, saturated fat and trans fat from your diet and you will cut your risk of diabetes. Include more healthy fats, fiber, whole grains, fruits and veggies, using the Nutrition Resource Center as a guide.

Quit smoking. Smokers are 50% to 90% more likely to develop diabetes than nonsmokers. If you smoke, taking steps to quit today can reduce your risk of serious health problems, including type 2 diabetes.

Drink moderately. Moderate drinking (no more than one drink daily for women or two drinks daily for men) has a protective effect against diabetes, but avoid heavy drinking.

If you have pre-diabetes, work closely with your doctor to create a plan of sensible lifestyle changes that will work for you. The complications of diabetes—heart disease, stroke, blindness, and more—can be avoided by taking these proactive steps today.

For more specific information or help, talk to your health care provider. The American Diabetes Association's National Call Center also offers live advice from 8:30 a.m. to 8 p.m. EST, Monday through Friday at 1-800-DIABETES or 1-800-342-2383.